Provider Demographics
NPI:1245574649
Name:POWERS, DANIELLE (MA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 N WHIPPLE CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-2525
Mailing Address - Country:US
Mailing Address - Phone:702-249-7927
Mailing Address - Fax:
Practice Address - Street 1:3651 LINDELL RD
Practice Address - Street 2:SUITE A2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-1254
Practice Address - Country:US
Practice Address - Phone:702-940-7896
Practice Address - Fax:702-940-8016
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health